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Important Information about Prescription Drug Coverage To:Fax completed form to: 18556337673 Questions, please call: 18772934998 24 hours a day 7 days a week (TTY users call: 711)From:Pages:Fax’Re:
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How to fill out online silverscript request for

01
Step 1: Go to the Silverscript website.
02
Step 2: Click on the 'Request Form' button.
03
Step 3: Fill in your personal information, such as name, address, and contact details.
04
Step 4: Provide your Medicare information, including your Medicare ID and Part D coverage details.
05
Step 5: Enter the prescription drugs you need to order and their corresponding quantities.
06
Step 6: Review the form for accuracy and completeness.
07
Step 7: Submit the online form and wait for confirmation of your request.

Who needs online silverscript request for?

01
Anyone who is enrolled in Medicare and requires prescription drugs covered under Silverscript can use the online request form.
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Online silverscript request is for requesting prescription drug coverage through the Silverscript online platform.
Individuals who are eligible for Silverscript prescription drug coverage are required to file online requests.
To fill out online silverscript request, individuals need to log in to their Silverscript account, enter necessary prescription details, and submit the request online.
The purpose of online silverscript request is to access and avail prescription drug coverage benefits offered by Silverscript.
Information such as prescription details, personal information of the individual, and any other relevant medical information must be reported on online silverscript request.
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